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1. ANOREXIA NERVOSA
A. Refusal to maintain body weight over a minimally normal
weight for age and height (eg, weight loss leading to
maintenance of body weight less than 85% of that expected; or
failure to make expected weight gain during a period of growth,
leading to body weight less than 85% of that expected).
B. Intense fear of gaining weight or becoming fat, even
though underweight.
C. Disturbance in the way in which one's body weight or shape
is experienced, undue influence of body weight or shape on
self-evaluation, or denial of the seriousness of the current low
body weight.
D. In postmenarcheal females, amenorrhea, ie, the absence of
at least three consecutive menstrual cycles. (A woman is
considered to have amenorrhea if her periods occur only
following hormone, eg, estrogen, administration.)
*Specify type:
-
Restricting type: during the current episode of anorexia
nervosa, the person has not regularly engaged in binge-eating or
purging behavior (ie, self- induced vomiting or the misuse of
laxatives, diuretics, or enemas).
-
Binge-eating/purging type:
during the current episode of
anorexia nervosa, the person has regularly engaged in
binge-eating or purging behavior (ie, self-induced vomiting or
the misuse of laxatives, diuretics, or enemas).
2. BULIMIA NERVOSA
A. Recurrent episodes of binge eating. An episode of binge
eating is characterized by both of the following:
(1) eating, in a discrete period of time (eg, within any
2-hour period), an amount of food that is definitely larger than
most people would eat during a similar period of time and under
similar circumstances
(2) a sense of lack of control over eating
during the episode (eg, a feeling that one cannot stop eating or
control what or how much one is eating)
B. Recurrent inappropriate compensatory behavior in order to
prevent weight gain, such as self- induced vomiting; misuse of
laxatives, diuretics, enemas, or other medications; fasting; or
excessive exercise.
C. The binge eating and inappropriate compensatory behaviors
both occur, on average, at least twice a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and
weight.
E. The disturbance does not occur exclusively during episodes
of anorexia nervosa.
*Specify type:
-
Purging type: during the current episode of bulimia nervosa,
the person has regularly engaged in self-induced vomiting or the
misuse of laxatives, diuretics, or enemas.
-
Nonpurging type: during the current episode of bulimia
nervosa, the person has used other inappropriate compensatory
behaviors, such as fasting or excessive exercise, but has not
regularly engaged in self-induced vomiting or the misuse of
laxatives, diuretics, or enemas.
3. EATING DISORDER NOT OTHERWISE SPECIFIED
The eating disorder not otherwise specified category is for
disorders of eating that do not meet the criteria for a specific
eating disorder. Examples include:
For females, all of the criteria for anorexia nervosa are met
except that the individual has regular menses.
All of the criteria for anorexia nervosa are met except that,
despite significant weight loss, the individual's current weight
is in the normal range.
All of the criteria for bulimia nervosa are met except that
the binge eating and inappropriate compensatory mechanisms occur
at a frequency of less than twice a week or for a duration of
less than 3 months.
The regular use of inappropriate compensatory behavior by an
individual of normal body weight after eating small amounts of
food (eg, self- induced vomiting after the consumption of two
cookies).
Repeatedly chewing and spitting out, but not swallowing,
large amounts of food.
Binge-eating disorder: recurrent episodes of binge eating in
the absence of the regular use of compensatory behaviors
characteristic of bulimia nervosa (see Table 29-3).
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